Jones v. Harrisburg Polyclinic Hospital

SPAETH, Judge,

dissenting:

I cannot agree with Judge PRICE’S statement that the doctrine of res ipsa loquitur1 is inapplicable in this case because a “review of the record fails to disclose sufficient evidence, as a matter of law, to eliminate Dr. Rohrabaugh as an ‘other responsible cause’ ” at 307.

It is settled that the doctrine of res ipsa loquitur as defined in section 328 D of the Restatement (Second) of Torts2 may be applicable in a case wherethere are multiple *386defendants. See Gilbert v. Korvette’s, Inc. 457 Pa. 602, 327 A.2d 94 (1974); Annotation, 38 A.L.R.2d 905 (1954).3 In Gilbert the plaintiff was injured by an escalator in a Korvette’s store. The Supreme Court held that res ipsa loquitur was applicable as an inference from circumstantial evidence,4 against both Otis Elevator Company and Korvette’s. The Court did not require the plaintiff to eliminate either Otis or Korvette’s, for the evidence supported the conclusion that they both were responsible causes of the injury. The Court stated: “[I]f responsibility is vested in and shared by two or more parties, each may be subjected to liability.” Id., 457 Pa. at 614-15, 327 A.2d at 101 (emphasis in original). And see W. Prosser, Handbook of the Law of Torts § 39, p. 221 (4th ed. 1971); Restatement (Second) of Torts § 328D, comment g (1965).5

*387The conclusion that a plaintiff may be entitled to an application of res ipsa loquitur against multiple defendants is especially important in medical malpractice cases where the plaintiff is injured by one or more of the operating room personnel. See Ybarra v. Spanguard, 25 Cal.2d 486, 154 P.2d 687 (1944); Fogal v. Genesee Hosp., 41 App.Div.2d 468, 344 N.Y.S.2d 552 (1973); Talbot v. Dr. H. W. Graves Latter Day Saints Hosp., 21 Utah 2d 73, 440 P.2d 872 (1968) (ELLET, J., dissenting); Annotation 82 A.L.R.2d 1262 (1962). The present case is such a case. The plaintiff produced evidence to prove that she was injured while unconscious in the operating room. She also produced evidence that the injury was probably caused by the improper positioning of her body *388on the operating table, and was not of a type to occur without negligence. See Fogal v. Genesee Hosp., supra (injury to part of body remote from that operated upon); Horner v. Northern Pacific Beneficial Association Hospitals, Inc., 62 Wash. 351, 382 P.2d 518 (1963) (same).

The plaintiff could not prove which specific person or persons in the operating room negligently positioned her on the table. However, in my opinion the inability on her part to point the finger at a specific nurse or doctor to the exclusion of all others should not prevent the application of res ipsa loquitur. I should not force the plaintiff to pick one person and try to eliminate all the others. Instead I should permit the plaintiff to subject all the defendants to res ipsa loquitur. Each defendant could then argue, and if he wishes, offer evidence, that he was not responsible, and also, that some one else was responsible.6 The jury would then decide whether the circumstantial evidence and the inferences arising from it were sufficient to hold any or some or all of the defendants responsible.

This approach to the problem of res ipsa loquitur and multiple defendants is supported by the case law, see Ybarra v. Spanguard, supra, and indeed is at least consistent with if not required by the Supreme Court’s decision in Gilbert. See Easter v. Hancock, 237 Pa.Super. 31, 346 A.2d 323 (1975) (where three doctors were all involved in inserting and removing hemostats all three were responsible for hemostat left in patient).

The major problem presented in this case is not the fact that there are multiple defendants but the fact that the plaintiff failed to sue one of her possible defendants, Dr. Rohrabaugh, who was present during part of the operation. If she had joined him as a defendant we should have a situation very similar to that presented in Gilbert. Perhaps this failure to join Dr. Rohrabaugh is the basis of Judge PRICE’S conclusion that res ipsa loquitur does not apply, the *389theory being that an unconscious patient plaintiff must sue all possible defendants in order to qualify for the application of res ipsa loquitur. If this is the basis of Judge PRICE’S conclusion, there is some support for it in the cases, especially those that follow Ybarra v. Spanguard, supra. For example, in Inouye v. Black, 238 Cal.App.2d 31, 47 Cal.Rptr. 313 (1965), where the plaintiff brought suit against the surgeon alone for negligence in an operation in which the surgeon had wired together his vertebrae and the wire had later fragmented into small pieces and caused injury, the court held res ipsa loquitur inapplicable. In so holding the court stated:

A group of persons and instrumentalities may combine in the performance of a medical procedure culminating in an unexpected, mysterious and disastrous result. With the sources of disaster personified in a group of defendants, the demand for evidence pointing the finger of probability at any one of them is relaxed; all may be called upon to give the jury evidence of care. . We do not have that situation here. Neither the firm which manufactured the wire nor the hospital which supplied it has been sued. The negligence of each is just as possible as some unspecified and indeterminate lack of care on the surgeon’s part. With only one of the several involved agents before the court, negligence could not be inferred without some evidence reasonably pointing to the surgeon.
Id. at 35, 47 Cal.Rptr. at 316.

See Spannaus v. Otolaryngology Clinic, 308 Minn. 334, 242 N.W.2d 594 (failure to join anesthesiologist who might have caused the neck injury). See also Talbot v. Dr. H. W. Grave’s Latter Day Saints Hosp., 21 Utah 2d 73, 440 P.2d 872 (1968) (HENRIOD, J., concurring) (commenting that if res ipsa loquitur should apply in such cases the plaintiff must sue all participants in the surgery).

However, the situation presented in this case is very different from the situation presented in Inouye; it more *390closely resembles that presented in Corcoran v. Banner Super Market, Inc., 19 N.Y.2d 425, 280 N.Y.S.2d 385, 227 N.E.2d 304 (1968). In Corcoran, the plaintiff was struck by a board that fell from a space between two abutting store premises. She brought suit against one store owner but not against the other and a verdict was rendered in her favor on the basis of res ipsa loquitur. The appellate division reversed, holding that res ipsa loquitur should not be applied where one who had joint control over the instrumentality of the accident — the other store owner — was not joined as a defendant. After a retrial the plaintiff appealed to the Court of Appeals, which reversed the decision of the appellate division and held that each store owner had a separate duty to maintain the board and that the shared or dual duty with respect to the board permitted the application of res ipsa loquitur against either or both owners. Thus, according to the Court of Appeals, it was not improper for the court in the first trial to permit the application of res ipsa loquitur against a single defendant. In Inouye, by contrast, the surgeon did not share responsibility with the manufacturer for the manufacture of the wire or with the hospital for storage of the wire.7

Here, as Judge CERCONE points out, Dr. Beittel admitted that he had the responsibility to preserve the patient neurologically during the surgical procedures. There was also expert testimony that as the operating physician, Dr. Beittel had a duty to monitor the positioning of the plaintiff. Therefore, even if we assume that Dr. Rohrabaugh may have been a responsible cause for the injury, still Dr. Beittel also was a responsible cause. Dr. Rohrabaugh may have shared with Dr. Beittel the duty to maintain the plaintiff and monitor her position, but there is no evidence that Dr. Beittel was excused from his duty by Dr. Rohrabaugh’s *391presence. Accordingly, under the principle applied in Corcoran, which I should apply here, the jury could justifiably hold Dr. Beittel liable as the responsible cause of the plaintiff’s injury, even though Dr. Rohrabaugh was not joined as a defendant.

I should affirm the decision of the court below.

. Section 328D provides:

“(1) It may be inferred that harm suffered by the plaintiff is caused by negligence of the defendant when
“(a) the event is of a kind which ordinarily does not occur in the absence of negligence;
*386“(b) other responsible causes, including the conduct of the plaintiff and third persons, are sufficiently eliminated by the evidence; and
“(c) the indicated negligence is within the scope of the defendant’s duty to the plaintiff.
“(2) It is the function of the court to determine whether the inference may reasonably be drawn by the jury, or whether it must necessarily be drawn.
“(3) It is the function of the jury to determine whether the inference is to be drawn in any case where different conclusions may reasonably be reached.”
Restatement (Second) of Torts § 328D (1965).

. In Loch v. Confair, 372 Pa. 212, 93 A.2d 451 (1953), where the plaintiff was injured by an exploding bottle of soda on a grocer’s shelf, res ipsa loquitur was applied against both the bottler and the grocer store owner.

. Res ipsa loquitur is not a presumption of negligence; it merely describes a factual inference that may be drawn from circumstantial evidence. See Restatement (Second) of Torts § 328D, comment b (1965).

. Comment g provides:

“Defendant’s exclusive control. The plaintiff may sustain this burden of proof with the aid of a second inference, based on a showing of some specific cause for the event which was within the defendant’s responsibility, or a showing that the defendant is responsible for all reasonably probable causes to which the event can be attributed. Usually this is done by showing that a specific instrumentality which has caused the event, or all reasonably probable causes, were under the exclusive control of the defendant.
*387Thus the responsibility of the defendant is proved by eliminating that of any other person.
“It is not, however, necessary to the inference that the defendant have such exclusive control; and exclusive control is merely one way of proving his responsibility. He may be responsible, and the inference may be drawn against him, where he shares the control with another, as in the case of the fall of a party wall which each of two landowners is under a duty to inspect and maintain. He may be responsible where he is under a duty to the plaintiff which he cannot delegate to another, as in the case of a landlord who leases premises dangerous to persons on the public highway, which his tenant undertakes to maintain. He may be responsible where he is under a duty to control the conduct of a third person as in the case of a host whose guests throw objects from his windows. It may be enough that the defendant was formerly in control, at the time of the probable negligence, as in the case of a beverage bottler whose product poisons the consumer, when there is sufficient evidence to eliminate the responsibility of intermediate dealers. Exclusive control is merely one fact which establishes the responsibility of the defendant; and if it can be established otherwise, exclusive control is not essential to a res ipsa loquitur case. The essential question becomes one of whether the probable cause is one which the defendant was under a duty to the plaintiff to anticipate or guard against.”

Restatement (Second) of Torts § 328D, comment g (1965) (emphasis added).

In Gilbert the Supreme Court gave the following example:

A, a pedestrian on the public sidewalk, is injured by the fall of a sign from the front of a building owned by B and leased to C. Both B and C are under a legal duty to members of the public using the highway to exercise reasonable care to inspect and maintain the sign. It can be inferred that the event was due to the negligence of both B and C.
457 Pa. at 615 n. 32, 327 A.2d at 102 n. 32.

. This does not mean that the burden of proof shifts to the defendant.

See note 4 supra.

. As it is unnecessary to this decision, I do not consider the validity of the rule set forth in Inouye but only note that an argument can be made that it should be the defendant’s responsibility to join any additional defendant he may believe to be liable.